003: Vomiting? Just “Normal” Cat Vomiting. There’s No Such Thing.

This episode we talk about all the "normal" cat vomiting, just kidding. There is no such thing as normal cat vomiting. Why are we talking about cat vomiting you ask? Well, its National Cat Day!!

Show Notes:

In This Episode…  
  
10/29/19: Celebrating National Cat Day with talking about “Normal Cat Vomiting”  

• There is no such thing as “normal vomiting” for cats! 

 Resources We Mentioned in the Show  

• IMFPP Blog Post: 
  • https://www.internalmedicineforpetparents.com/vomiting-versus-regurgitation.html 
  • https://www.internalmedicineforpetparents.com/ultrasound.html 
  • https://www.internalmedicineforpetparents.com/vitamin-b12-in-dogs-and-cats.html 
• Texas A&M GI Lab: 
  • https://www.cvm.tamu.edu/gilab/research 
• ACVIM Abstract: 
  • https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1939-1676.2003.tb02465.x 
• ​Link for Client Questions is in the Technician Treasure Trove:
  • ​Sign up to our newsletter, get your password, and then down the "Vet Visit Checklist For Clinical Staff"

 
Thanks so much for tuning in. Join us again next week for another episode!  
  
Listening Options  

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•  Subscribe on Apple Podcasts or your favorite podcast player for free!  
•  If you enjoyed this episode, rate and leave us a review wherever you can!  

Contact Us!   

• If you want to get involved, leave us a comment!  
• Visit us and give us a ‘like’ on our Facebook page! 
  • ​https://www.facebook.com/internalmedicineforvettechs  
• Email us at podcast@internalmedicineforvettechs.com   

  
Thanks for listening!  
– Yvonne and Jordan  
 

003 Vomiting? Just "Normal" Cat Vomiting. There's No Such Thing transcript powered by Sonix—the best audio to text transcription service

003 Vomiting? Just "Normal" Cat Vomiting. There's No Such Thing was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2019.

Yvonne Brandenburg, RVT, VTS SAIM:
Welcome to the internal medicine for that text podcast. If you haven't joined us before, we're passionate about all things internal medicine and helping you become the best tech you can be. We'll be discussing interesting internal medicine diseases, how to work closely with pet parents, and how to become the go to tech in your practice. Now let's start the show.

Yvonne Brandenburg, RVT, VTS SAIM:
Hey, welcome back everybody! We're super excited that you are still with us for our third episode of the podcast! If you haven't listened to the first two, I am Yvonne, I am going to be one of the co-hosts for the show and I am joined by Jordan.

Jordan Porter, RVT, LVT VTS SAIM:
Hi. I am also officially a co-host.

Yvonne Brandenburg, RVT, VTS SAIM:
You are officially a co-host, for sure.

Jordan Porter, RVT, LVT VTS SAIM:
I've bought a new mike and everything.

Yvonne Brandenburg, RVT, VTS SAIM:
I know, right? So speaking of recording and how we sound, I want to warn everybody, we did not record episode 0 through 6 in the same play order as recording. So unfortunately, I will warn you, there are a couple of episodes where I recorded on my computer microphone and then Jordan recorded on the microphone she had. And we both listened back and realized that the sound quality just wasn't that great. So we've officially both upgraded our microphones, so hopefully this will be more the norm for all of the episodes after probably five/six where we sound a little bit more like we're not talking in a tunnel. But Jordan got an official microphone, which is exciting.

Jordan Porter, RVT, LVT VTS SAIM:
I'm super excited.

Yvonne Brandenburg, RVT, VTS SAIM:
Speaking of being excited, we're glad that you have decided to join us on this learning experiment. We are talking all things internal medicine. And this week, we are, we're diving into the world of "normal" cat vomiting.

Jordan Porter, RVT, LVT VTS SAIM:
Because if you're a technician, you can bring up nasty things like vomiting in like a normal conversation.

Yvonne Brandenburg, RVT, VTS SAIM:
So we're you were discussing vomiting and in case you're, you know, driving to work. It's totally normal to talk about vomiting while driving to work. It's so relaxing. But the reason we're talking about, quote unquote, normal cat vomiting is we are celebrating National Cat Day. So today we when this episode goes live, it's October 29th, 2019 and it is the National Cat Day. So what better way of than to talk about the vomiting that we see our cats for.

Jordan Porter, RVT, LVT VTS SAIM:
Yes. Frequent, frequent, normal cat vomiting. Those clients who come in and they're like, oh, my cat vomits probably every other day. But that's normal for her or him.

Yvonne Brandenburg, RVT, VTS SAIM:
Oh my God. How many times have you heard that from a client? Oh, it's, you know, he vomits, but it's normal cat vomit.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. Which then I'm like, but it's not, like do you vomit every day?

Yvonne Brandenburg, RVT, VTS SAIM:
Why do you vomit every day? That I that that phrase goes through my head every single time. I'm like, there is no such thing as normal vomiting for any animal. Like. Yes. Some animals have. What is it you eructation? Do remember that for the four chamber stomachs?

Jordan Porter, RVT, LVT VTS SAIM:
Yes. Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
But that's not vomiting. And cats are not herbivores. They're carnivores.

Jordan Porter, RVT, LVT VTS SAIM:
Rant.

Yvonne Brandenburg, RVT, VTS SAIM:
I don't, I don't ever rant. What are you talking about?

Yvonne Brandenburg, RVT, VTS SAIM:
No, it's. It's completely harmful. Just like cat vomiting.

Yvonne Brandenburg, RVT, VTS SAIM:
Wait! Are you saying my tech rants aren't normal?

Jordan Porter, RVT, LVT VTS SAIM:
Hey, my tech rants are just up there, too.

Yvonne Brandenburg, RVT, VTS SAIM:
So we decided that we would talk about something that drives us crazy, especially in internal medicine, because we do see cats come in quite a bit for vomiting. So just a reminder. What exactly is vomiting? So, I love this. The Merriam Webster's dictionary defines vomiting as an act or instance of disgorging the contents of the stomach through the mouth. It is also,

Jordan Porter, RVT, LVT VTS SAIM:
I do love that description.

Yvonne Brandenburg, RVT, VTS SAIM:
Also known as vomiting. Or emesis. Yeah. I mean, I think I think everybody knows what vomiting is. But I think it's a good reminder to talk about the difference of vomiting versus regurgitation. So I will a lot of times when I when I'm getting my history from clients, I ask them vomiting or regurgitation. Most clients have absolutely no clue what regurgitation is. So they just say, yeah my animal vomits. So just, you know, it's important as a technician to get the most thorough history that we can. So it makes things easier for our doctors. What I usually do is, OK, first I ask them, have you seen them vomit? You know, because sometimes they just find vomit, especially cats. Right. We just find, you know, in the middle of the night when you don't have shoes on.

Jordan Porter, RVT, LVT VTS SAIM:
Oh, yeah. Getting out of bed.

Yvonne Brandenburg, RVT, VTS SAIM:
That's where we find the vomit slash hairball grossness.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. Great.

Yvonne Brandenburg, RVT, VTS SAIM:
So it's you know, it's that question of did you see it or did you did just find it? And then I always go. So do you see it? And they say, yes. OK. So were they doing the "herk-herk-herk" thing, you know, I'm like, yeah, the whole movement and coming up and it comes up or is it really actually regurgitation where it just comes up? So like I usually say, you know, kind of like an acid reflux type thing and then people know.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. There's no effort to it.

Yvonne Brandenburg, RVT, VTS SAIM:
And then people tend to understand it. The other thing I asked them, too, which is sometimes an indication of regurging versus vomiting. I asked them, you know, do they burp up stuff and then just kind of chew and swallow it down. Right. That's more right. Again, we're all in the field. So if this grosses you out, you're probably listening to the wrong podcast because we'll get we'll get grosser, I'm sure, at some point. But yeah, it's big to know the difference between the two.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. Well and you're just like anatomy of it. If it's vomiting or regurg, you know you're looking upper G.I. tract. So esophagus more like regurg when pets have megaesophagus or a congenital issue.

Yvonne Brandenburg, RVT, VTS SAIM:
Or esophagitis.

Jordan Porter, RVT, LVT VTS SAIM:
Gastritis, or obstructions. There's some many.

Yvonne Brandenburg, RVT, VTS SAIM:
There's a long list. Yeah. And one thing too, if you know, if you want to send things to your clients we do on our Web site. Well on one of the websites. So www.internalmedicineforpetparents.com, so more geared towards the pet owner, we do have a post about vomiting versus regurgitation. And so it's, you know, you can definitely share that with them. We'll put a list in the show notes or link in the show notes so you can you can check that out. But it is a good idea. Like like Jordan was saying, you know, we we have to figure out what's causing the vomiting versus regurg. And so thorough history is huge. So one of the big things about, knowing our pets, our patients really that are coming in with it is, really any age pet, any breed, any species can can do this. There's not really a predisposition to vomiting. I would say when we're looking at differentials as far as, you know, what's going on, typically, although it's not guaranteed. But typically, you know, when I'm thinking young animals, young cats, I would worry about like a foreign body, especially if it's something that happened recently. It's not a chronic thing. Congenital.

Jordan Porter, RVT, LVT VTS SAIM:
I love the congenital ones.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. So people have congenital that you can think of.

Jordan Porter, RVT, LVT VTS SAIM:
So it's like that fun mystery game where you like, why do I have a one year old cat coming in and vomiting or regurgitating? And turns out it's actually regurgitating and there's a persistent right aortic arch. That's probably I mean. It's not great for the pet, but that's a good example, good mystery to solve. And then mega esophagus can definitely be congenital. That one's not as fun, but,

Yvonne Brandenburg, RVT, VTS SAIM:
Or some odd cardiac sphincter issue. You know, maybe it doesn't close all the way, you know, is there are esophagitis. And I've actually seen this where parasites can cause irritation, reflux, or regurgitation, or vomiting. So we you know, we look at that. And the other thing, too, with younger pets is toxins. So because cats.

Jordan Porter, RVT, LVT VTS SAIM:
Yes. Kitty cat.

Yvonne Brandenburg, RVT, VTS SAIM:
Because kitty cats like to eat and chew on all sorts of crap. Right. So we look for those things and we ask those in-depth questions to try to rule those out. Older pets, especially older cats. You look for metabolic disease. You guys know what that means, right? So things within the body that's causing the vomiting.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. So common common things. I think it used to be definitely. Well, still is one of my first thoughts when I see an old cat come into the clinic or the hospital for vomiting is hyperthyroidism. That's definitely a huge one. But then there's obviously other diseases that will kind of get into based on the history that you obtain from your patient or from your client. Just you want to get a thorough history if there's a chance that the cat got into anything. Even if it is older, chronic issues, it maybe this turns out this is normal for the cat to vomit once a day for the last seven years. Any medications that might be on or parasite exposure? I know a lot of questions around my clinic are when was last time like you had your yard sprayed or your house sprayed for bugs or parasites or mosquitoes. And that can be a big one too. As if your cat was in the corner and licking it.

Yvonne Brandenburg, RVT, VTS SAIM:
Right. Yeah. And I think people are becoming more conscious of that. But , you know,

Jordan Porter, RVT, LVT VTS SAIM:
Definitely.

Yvonne Brandenburg, RVT, VTS SAIM:
We have to keep in mind that our clients don't know as much about this as we do. And we may have a client who's never owned an animal before. And so their experience of normal is what this animal's doing. But in reality, that's not normal. We've created a handout for you. That is a list of history questions. So when you're going into the room, questions you should be asking every single patient, every time, just to see, you know, what's going on. And we have one that's, you know, for your initial consult, your initial time seeing them versus like a recheck appointment. Right. You don't need quite as much for a recheck as you do as a consult or your initial, you know, seeing this pet for this problem. So we'll have that for you guys to use and we'll put it in the show notes. We'll put a link in there, because I think that's huge is understanding what's going on and making sure you're asking questions that are not going to give you subjective answers. And also, hopefully not be yes or no. Right. You want to. Well, there are some that are going to be more yes or no or: yeah, that happens. What's the frequency? Describe you know, description is good. And so. So we'll have those questions and you can check it out the in the show notes. We'll have the hand out for you.

Jordan Porter, RVT, LVT VTS SAIM:
I think it's good to have cats like especially like I think one thing that I don't think a lot of people think to ask is if there's been a change in the environment. Cat's get stressed easily.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah, that's a great question. So for sure.

Jordan Porter, RVT, LVT VTS SAIM:
Because especially I mean, we have a lot of people where I am, move or are here for the summer. And so I think a lot of that is they brought their cat with them. And now they're cat doesn't really want to eat and is vomiting every day multiple times a day. So that can be an indication of something going on as well.

Yvonne Brandenburg, RVT, VTS SAIM:
And change in environment, you know, not just vomiting, but there can be things that they're allergic to in the environment, too. And so that can cause issues. And, you know, one thing to remember when asking about vomiting in regards is hairballs. Specifically use the word hairballs because most clients do not think a hairball is actually vomiting, which kills me. I'm like, why? Why do you not think something coming out of the mouth is vomiting? They're like, it's a hairball. That's normal. No, hairballs are not really normal.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, especially if your cat's like excessively grooming. That can also indicate another underlying issue, whether it be pain or discomfort of some sort. And then they're just excessively grooming their abdomen and then so they then in turn form your balls. And I don't know, but I'm sure you've, I'm sure you've seen like obstructive hair.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. It's just funny because I feel like those usually have some underlying problem.

Jordan Porter, RVT, LVT VTS SAIM:
Yes, definitely. I think the last one I saw was lymphoma.

Yvonne Brandenburg, RVT, VTS SAIM:
Because there's a lymph node that's giant now the hairball can't get through. So it's you know, when when you say hairball. Yeah. If you've got like a hairball every 6 to 12 months. Yeah. It's a long haired cat. Sure. That can be OK. But you know, if they're once a week. Once every other week, hairballs, that's not normal, you know. Remember, there's no such thing as a petroleum deficiency in nature. So laxatone. It's not a thing. like cats don't go out and get laxatone because of their hairballs. So just just remember that.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
So the the other big thing about hairballs that I thought was super interesting when I started working in internal medicine, it didn't I don't think I'd heard this prior to working in internal medicine. Hairballs can also indicate respiratory disease. Which is very interesting. So cat coughing, a lot of people think that a cat coughing is actually the cat trying to vomit. We actually had a cat just this week, beautiful Himalayan long haired cat, has small cell lymphoma, as well I believe a little bit of kidney disease. And so we're talk we're getting him in for respiratory distress and we're like, wow, you know, like you have GI disease, you have kidney failure. Oh, my God. Now you have heart issues, we just went there because we're like, why wouldn't you have heart issues?

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, exactly.

Yvonne Brandenburg, RVT, VTS SAIM:
We did chest x rays. We also had the cardiologist take a listen to him once he was a little bit more stable, obviously. We kind of got him stable before we did all this. It turns out he's got asthma. So mom had been treating his, quote unquote, trying to vomit with cerenia for months. And so she finally got a video of what he was doing. After a while, it was on a recheck. So I was like, wait, what's going on with him? And I pulled up a video online and was like, is this what he's doing? And she was like, that's exactly what he's doing. And it was actually him coughing. So we've had like two or three follow ups since then. And she's like, I think he's better. She's like, I don't think he's vomiting now, but I. The coughing seems better. So she you know, she just thought it was vomiting when in fact, it was really him coughing.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. It's interesting, though, because if he was on cerenia and cerenia has that off-label use for cough as like a cough suppressant. So I'm sure it's just like masking it at the signs of what he's experiencing.

Yvonne Brandenburg, RVT, VTS SAIM:
I was like a little inflammatory and he gets better. Yeah, exactly. And so he's actually on an inhaler now which he's tolerating, which is great. But you know, it's a reminder to not make assumptions about what's going on with cats. We've had these respiratory like chronic bronchitis cats that come in. You know, they were having frequent hairballs because what's happening is they're coughing so hard, they make themselves vomit. So that's just something to kind of keep in mind. I don't know if you guys have ever had a really bad cough.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. I was just thinking that. I was thinking I've been there.

Yvonne Brandenburg, RVT, VTS SAIM:
Cough and you're just like, your whole bo oh. And then you vomit. It's it's that.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, exactly. And like your whole body hurts from it.

Yvonne Brandenburg, RVT, VTS SAIM:
It's the most miserable thing. Could I go to bed now?

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, exactly.

Yvonne Brandenburg, RVT, VTS SAIM:
It's good to remember we are mammals.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. All right. I think it important though to to ask is just be sure how frequent is this cat vomiting? Because again like people are gonna say it's normal. Well how normal or how frequent is normal for them? Some people will say once a day, every other day, once a week, once a month, maybe a long haired cat, twice a year for a hairball, but not really any more than that. Like people need to remember, you don't vomit every day. At least I hope you do.

Yvonne Brandenburg, RVT, VTS SAIM:
If you do, you should seek medical advice. Just saying.

Jordan Porter, RVT, LVT VTS SAIM:
Not from us.

Yvonne Brandenburg, RVT, VTS SAIM:
You can also ask them if there's a pattern to it. So are they seeing more in the mornings. They haven't gotten fed yet and they vomit. So we have some pets that with an empty stomach they get really noxious and they will vomit. Is it right after they eat food. So everything that comes up is food and not, you know, yellow bile or foam or, you know, are you seeing anything else? I hope you're not seeing blood. So remember to ask them, is it frank red blood? Is it. Does it look like coffee grounds? I love when people take pictures of things because that is not subjective. That is now objective because I can see it. So asking your clients to bring in pictures or videos.

Jordan Porter, RVT, LVT VTS SAIM:
And then too if it is after eating, how long after eating? Because that's going to also help you determine if it's vomiting or regurg. So that's pretty important, too. And then I know a lot of I've had several clients come and be like, well, we pushed feeding up because my cat seemed hungry at 5 p.m. So now I feed at 5 p.m. but he vomits overnight sometimes. And he doesn't eat till 8:00 a.m. So yeah, I think timing of when things are given and when things are noticed is pretty important.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. And to kind of go along with that is asking them to, you know, when did they eat? And let's say they got fed at 8 o'clock at night, you know, in there they don't get anything overnight. Cause they don't free feed because it's a fat orange cat, so they feed it eight o'clock at night and in the morning, you know, it's eight o'clock again and they vomit, but they haven't gotten breakfast yet. Yet food is coming up. Right. That tells you a lot. That means that the stomach isn't emptying appropriately. So, you know, again, thorough history, getting as much information as we can for our doctors to help them make informed treatment plans.

Jordan Porter, RVT, LVT VTS SAIM:
Right. Yeah. Because when you're obtaining a history, too, and you do hear like a situation like that where my cat hasn't eaten since 8:00 p.m. last night, but vomited up undigested food at 7 a.m. You have to remember that cat stomachs should empty within four to six hours of meal. So I think that's pretty important, too, when realizing that that should be an indication that something is wrong.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. And the other thing to go along with that is, you know, grass. Eating grass is not harmful unless it's just like chewing on stuff, but chewing on stuff to make themselves vomit, it's not normal. So especially if you have a cat, that's not a normal chewer of grass. Like, you know, there's the behavioral, "I love grass. I'm going to chew on it" vs. Oh yeah. Like once a month. He just chews on grass and then he vomits.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. And those cats who love to chew on things usually also like to chew on like plastic bags and other things can cause other vomiting.

Yvonne Brandenburg, RVT, VTS SAIM:
Are you talking about my cat? That's my favorite.

Jordan Porter, RVT, LVT VTS SAIM:
Chews on the microphone.

Yvonne Brandenburg, RVT, VTS SAIM:
Oh no, no chewing but rubbing on the microphone. I would kill them if they chew on it.

Jordan Porter, RVT, LVT VTS SAIM:
It's their microphone.

Yvonne Brandenburg, RVT, VTS SAIM:
Everything is theirs. Let's be real. It's a cat.

Jordan Porter, RVT, LVT VTS SAIM:
Right. Yeah, exactly. So I think then going back into when did it all start? How long has this vomiting been going on? Has it been chronic for years? Has it been recent within the last couple days? Do meds help? You're one patient that you had. This cerenia may have helped, but then it turns out was coughing but could have still helped. So you need to find out if the meds don't help, then obviously instead of refilling cerenia, try something different. And then, of course, eat something unusual where they eat a plastic bag or they found pieces of a plastic bag.

Yvonne Brandenburg, RVT, VTS SAIM:
Or string.

Jordan Porter, RVT, LVT VTS SAIM:
Tinsel around Christmas. Or a plant in general like a leaf.

Yvonne Brandenburg, RVT, VTS SAIM:
Exactly. Yeah, especially if they go outside. I mean, that's that's a really good point to is asking client, you know, do they have these plants in their backyard or do their neighbors have it? Because you want to make sure we can rule that out. Like the big one that's that we talk about right now is Sago Palms.

Jordan Porter, RVT, LVT VTS SAIM:
Ok. You do have those too.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. I have like six of them in my front yard, but my dogs don't go out there. But yeah, that's a common occurrence. And obviously that's definitely more geared towards dogs and cats, I feel. But it still can happen. I think people just assume that because they're cats only stay on the patio, they can't get into a Sago Palm.

Yvonne Brandenburg, RVT, VTS SAIM:
Right. Or a Lily, that's in your neighbor's yard. Yeah. Knowing that is is big.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, definitely. I think a huge tip for like just knowing your general area and what toxins outside can be around you. Knowing what plants are around you, what snakes, snakes or big things around here.

Yvonne Brandenburg, RVT, VTS SAIM:
I was like "Oh god, not snakes." We have spiders though.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. Well we have Blackwidows and stuff too. And all of those things can actually cause a pet to vomit. On intake, yeah, if your client noticed a spider under the table and then your cat was under there playing or something and now the spider is missing but the cat was vomiting, it could indicate something.

Yvonne Brandenburg, RVT, VTS SAIM:
Travel history. So I for the longest time did not ask my cat owners if their cats travels because I just would be out any move or anything like that. But, I asked it to one of my clients one time and he was like, oh, yeah. Well, you know, Zippy's been to Nebraska, and Wyoming, and we took them in the RV to go, when we went to Yellowstone National Park and I was like, "oh". So this cat literally went with him everywhere in the RV.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, we had a cat like that too.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. So don't assume that cats aren't traveling. You know, I think in my head, I think traveling cats, I think show cats. But yeah, I don't see a lot of show cats. I mean I probably see a few but not many. But, you know, cats cats do travel. So asking, you know, where they got them? You know, did they come from another part of the country or another part of the world? I also had a dog that came from Iran one time, which that's a whole other story. But, you know, just making sure you know where animals are coming from.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, definitely. And I think just I think we briefly mentioned it earlier, but like environmental changes, or diet change, bowl change, and changes and treats or maybe your treats do say "new and improved" and now you might be having a problem. Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
Diet change at diet change is huge. Speaking of. Sorry, I know plenty of people who think their cats and dogs get bored with a certain food and that's why they stop eating.

Jordan Porter, RVT, LVT VTS SAIM:
Yes.

Yvonne Brandenburg, RVT, VTS SAIM:
It actually can indicate a food aversion. Especially if you have a kidney cat, right? Kidney cats are the worst because kidney failure makes them feel noxious when the toxins build up in their system. So what I tell my kidney cat owners is, I don't care which one you end up picking, but I usually say go with the Hill's K/D, maybe go with the Royal Canin Renal diet, and the Purina NF. You buy all the flavors, all the textures, and then once your cat stops eating the one, you switch to the next one and then they'll eat that for a little while. And then once they stop eating that, go to the next one. But then you can always go back to the one's they ate previously because usually what happens is they feel nauseous, so they stop wanting to eat that one particular food or flavor or texture. But then you know, after a while they kind of forget that they don't like that one because they're like "oh yeah, I like that one again". So you don't have to throw it out. You don't have to get rid of it. You can't potentially just keep it in your shelf and come back to it later. And that way they're staying on a kidney specific diet. You're helping prevent the nausea because of buildup of toxins with the other food. And for cats, that's a big thing. So try to avoid, you know, the other foods that are going to make them feel worse long term. Especially if they were eating to begin with versus they never ate it. They hate it to begin with. Like, that's different. But if they ate it and they liked it, keep it in your back pocket. Come back to it again.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. Yeah. But I do think that like the frequent changes of diets before G.I. issues can definitely. There was a study off to find it. There was something out there about how frequent changes in diets and proteins that the pet eats can actually cause food allergies and then cause the vomiting and stuff. And then, of course, too, if it is a food allergy and you've already tried or given your pet all the diets throughout its life, then it does make it harder to find that novel protein that they've never had before in order to put them on a hypoallergenic diet.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. And speaking of novel proteins, I will soapbox. I'm sorry. It's a "tech rant". Tech Rant number 2.

Jordan Porter, RVT, LVT VTS SAIM:
We should make a little diddle for that.

Yvonne Brandenburg, RVT, VTS SAIM:
A little diddle like a lion roar?

Jordan Porter, RVT, LVT VTS SAIM:
A little song.Yeah!

Yvonne Brandenburg, RVT, VTS SAIM:
So my Tech Rant on food. I am a big firm believer of a prescription diet versus an over-the-counter diet. And it's not that it's a specific brand for me. The big three brands that we think of is going to be Hill's, Purina, and Royal Canin. They have prescription diets. Those diets are specially formulated for the diseases. They also have very strict control of their food and they do voluntary recalls. One of the biggest things I have a problem with is when people say, "oh, but they were recalled". Yes, but it was a voluntary recall because the food that they made did not meet their standard. Not, nobody else got involved, they voluntarily recalled whatever it was, because it didn't meet something.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
And when we're talking especially novel protein diets, it's very important to know which company you're using and what their practice of making that food is. Because the big ones that have that they have specific factory like lines that only make that food because they don't want to cross contaminate with other proteins and other things that can be allergic. In that novel, protein, food. And I like telling clients, and you can use this analogy for clients if they don't understand food allergies or food sensitivities, just tell them peanuts. Right?

Jordan Porter, RVT, LVT VTS SAIM:
Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
Everybody understands peanut is an allergy. One person, if they eat a peanut and they just have a little bit of a sensitivity, maybe they just get a little bit of an upset stomach. Versus a person who has a peanut allergy, maybe they go into anaphylactic shock and they need to be rushed to the hospital. It depends on the immune system, how extreme they're gonna get, you know, how much vomiting they're gonna have. How much GI upset. So it's just it's really important when we're talking to clients for them to understand that you don't necessarily want to use an over-the-counter food because they don't have those strict controls of what potentially could be in the food. So that is my Tech Rant about prescription diet.

Jordan Porter, RVT, LVT VTS SAIM:
And then so I think what that's kind of leading into those the causes for vomiting. So you got to determine acute versus chronic. So how long it's been going on? Chronic is longer than three months. And that can be off and on, consistently, off and on. So it's like consistently once a week for three months or longer. That would be a chronic thing. Or those pets who are chronically vomiting for a week and then they get better and then they vomit again for a week and then they get better.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah.

Jordan Porter, RVT, LVT VTS SAIM:
But the acute can be diet changes, obviously, as we just talked about. Parasites, of course, especially in the younger patients or outdoor kitty cats that people rescue and show up on their front porch, but this cat vomits every day. And then, of course. Well, again, infectious diseases. You pick up that stray cat off of the front porch.

Yvonne Brandenburg, RVT, VTS SAIM:
I have one of those. It's cool.

Jordan Porter, RVT, LVT VTS SAIM:
They're the best. Let's be honest.

Yvonne Brandenburg, RVT, VTS SAIM:
Actually, I have two of those. Oh great. Both of my cats leftover were strays.

Jordan Porter, RVT, LVT VTS SAIM:
That's another story.

Yvonne Brandenburg, RVT, VTS SAIM:
Tech cats. What can you say?

Jordan Porter, RVT, LVT VTS SAIM:
They all have a problem. I mean, how do you think I ended up with five dogs?

Yvonne Brandenburg, RVT, VTS SAIM:
I don't know, but that's a lot of dogs.

Jordan Porter, RVT, LVT VTS SAIM:
It's a lot of dogs, just saying.

Yvonne Brandenburg, RVT, VTS SAIM:
Oh, one thing that you were kind of talking about, the kind of chronic vomiting, keep in mind, if a pet has a food allergy. Let's just go with that. And let's say once a month they have vomiting, but then they're fine. It's like a week of vomiting. Ask them when they give heartworm and flea prevention? Because a lot of times it's once a month. Or maybe it's every three months. So because they could be allergic to something in that in that medical.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
We've found a couple of those. We're like "yeah let's do topical" and then they're fine.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. When you got to look into the medications too, especially if they've just started a new joint supplement or something like that. Anything with those additives in it or they had something compounded and it has this bacon flavor that's really made for like fish products or something weird.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. And and and also the gelatin caps there. We have some animals that are allergic to that. So that can all cause vomiting. Yay. Vomiting.

Jordan Porter, RVT, LVT VTS SAIM:
So many things can cause vomiting. So you got the foreign bodies, of course, which I got to say, I do enjoy a good foreign body here and there.

Yvonne Brandenburg, RVT, VTS SAIM:
You know what I like about foreign bodies?

Jordan Porter, RVT, LVT VTS SAIM:
Is it's fixable.

Yvonne Brandenburg, RVT, VTS SAIM:
It's fixable. Exactly! You know, most of the times, I mean, yes, unfortunately, there are some cases that's not the case, but most times they feel like crap and then they have surgery and then they go home and they live a happy life.

Jordan Porter, RVT, LVT VTS SAIM:
I know like you like never see them again, but then they're just wonderful like that. But then, I already said parasite's food sensitivities? IBD. We briefly touched about lymphoma, but inflammatory bowel disease is more common than I think I realized when I was working in general practice.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah.

Jordan Porter, RVT, LVT VTS SAIM:
And same with lymphoma. I don't think I realized how how frequent intestinal lymphoma was versus the normal lymphoma.

Yvonne Brandenburg, RVT, VTS SAIM:
Right? And I think, you know, we're going to talk about diarrhea, which vomiting and diarrhea, definitely inflammatory bowel disease and lymphoma are big on that list to make sure that our animals don't have it. We'll talk about I'm sure we can probably have an inflammatory bowel disease episode.

Jordan Porter, RVT, LVT VTS SAIM:
Oh, for sure.

Yvonne Brandenburg, RVT, VTS SAIM:
Because there's different ways to treat it, there's different causes for it. So, you know, just getting your history known with the vomiting, diarrhea, regurgitation, all that stuff is huge. We talked about asthma as being kind of a differential for why we're vomiting. And another one that I thought was interesting is heart disease.

Jordan Porter, RVT, LVT VTS SAIM:
Yes.

Yvonne Brandenburg, RVT, VTS SAIM:
Which I thought my doctor was crazy when she just suggested it. But you get this interest thing. I am not a cardiology technician, so I don't work with it a lot. I'm fortunate I have a cardiologist in our clinic, so they deal with it. I usually don't. But, you know, if an animal has heart disease, you can get that fluid overload, which also can go into the gut, which can cause diarrhea and it can cause vomiting. So, you know, that's something to keep in the back of your head and not just coughing, but also GI upset from heart disease, which is kind of crazy, actually.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, it's unreal. And then, of course, like the metabolic diseases we talked about the kidney disease, thyroid disease, diabetes, liver disease.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah, all the things!

Jordan Porter, RVT, LVT VTS SAIM:
All of things can cause vomiting. So it is a pretty big differential list when you start out and you're in a room with the patient who's vomiting. But I think trying to get down the basic information of what your patient is actually experiencing would narrow down that list pretty quickly.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah.

Jordan Porter, RVT, LVT VTS SAIM:
And then, of course, like, what skills do we. I mean, I think that's why hopefully people are listening is to gain a little bit of knowledge and gain some skills. So what skills are we using when we are assessing these patients or dealing with these patients?

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. And I think technicians play a huge role as far as, not just history, right? And talking to our clients, but also the diagnostics. Right? So our doctors order the diagnostics they want. There's very few that they do. Most of the times it's us. So it's huge. And we do most of our patients when they come in, getting baseline lab work is huge. No matter what disease it is, right? So we want to rule out is it a metabolic disease that's causing it? Or is it mechanical? Right. A functional disease. So we want to look at those. And we talked about like renal failure, pancreatitis, thyroid disease. Those are more metabolic, although pancreatitis is also mechanical because it's got a exocrine and an endocrine function.

Jordan Porter, RVT, LVT VTS SAIM:
And so that's coming, soon.

Yvonne Brandenburg, RVT, VTS SAIM:
We'll be talking about that as well. And so, you know, getting that baseline lab work helps tremendously. So your your chemistry, your full chemistries, electrolyte, CBC, ideally, you know, a T4 thyroid check. So those should be in your basics as well as a urinalysis to look.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
Are the kidneys concentrating? Is there an infection? Right. Infection can definitely do that. We didn't actually know about that. Urinary tract infections.

Jordan Porter, RVT, LVT VTS SAIM:
I mean pylonephritis is...

Yvonne Brandenburg, RVT, VTS SAIM:
And also to check to see if they're hydrated. Right? Is there blood super concentrated. And now we're dehydrated. So we have to work with that. So getting getting the blood work is huge.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. And then I personally enjoy imaging. I do like obtaining radiographs and holding for ultrasounds. Ultrasounds are my favorite. But that's just because I've been around them so long. And I think now I think I know what I'm seeing.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. I love ultrasound.

Jordan Porter, RVT, LVT VTS SAIM:
I love guessing.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. It's funny because my doctor that I work with, she a lot of times will get, you know, a phone call or she gets something else where she can't come into ultrasound right away. Yeah. And so I've gotten into the habit now that I just start looking.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
And it's fun because I'm like, "look what I found". And this is usually what I do. I go, "hey, hey, doctor, I think this dog has a foreign body".

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. Right?

Yvonne Brandenburg, RVT, VTS SAIM:
And then she'll be like, "yep, great". You know. So that was fun when when I started being able to see things.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, I do love that game.

Yvonne Brandenburg, RVT, VTS SAIM:
We can do that. Right? It's not illegal for a technician to get imaging.

Jordan Porter, RVT, LVT VTS SAIM:
No.

Yvonne Brandenburg, RVT, VTS SAIM:
So you know, again, practice.

Jordan Porter, RVT, LVT VTS SAIM:
Doctor preference. Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. There are...

Jordan Porter, RVT, LVT VTS SAIM:
There's courses you can take.

Yvonne Brandenburg, RVT, VTS SAIM:
I would gonna say there's courses. They're looking at certification for it, which is awesome. If you really like imaging the VTS in imaging, which...

Jordan Porter, RVT, LVT VTS SAIM:
I think it's in, I think they're just now accepting applications, or in the process of it. What is it? Advanced diagnostic imaging?

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. I believe that's, we'll put a link to them as well in the show notes. I looked at it because I really wanted to do it, but there's a lot of large animal stuff on it. I was like, well, that's not happening because I'm a small animal practice only kind of person. So unfortunately, I couldn't do it. But we also, you know, when we're talking about diagnostic imaging, let's say you have an animal that's regurgitating or not able to swallow or anything like that, you can do a swallow study with fluoroscopy. I personally have not done one, but I've seen the images from it. It's really cool. And you could see, you know, how is the food bolus going down the esophagus and how is it entering into the stomach? So that's really cool.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, that would be great. And of course, well, in general practice, obviously, more of just like the normal contrast studies you can do as well as study with barium or omnipaque. Caution of watching for aspiration pneumonia. That is bad with barium. I think my surgeons, if we have to if we absolutely have to do some sort of contrast study, they prefer omnipaque over barium. So that's helpful.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. And the reason for that is they don't want barium in the abdomen. Like that is all sorts of bad but omnipaque because it can go IV. It's OK.

Jordan Porter, RVT, LVT VTS SAIM:
Yes, definitely. And procedures, I am a big fan of endoscopic procedures. I know that's not generally done in general practice. But I've done it I think a few times in one practice, in general practice.

Yvonne Brandenburg, RVT, VTS SAIM:
But yeah. And we can we can definitely talk more in depth about endoscopy because I think that's a whole thing.

Jordan Porter, RVT, LVT VTS SAIM:
That's a whole episode on all the endoscopic procedures.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah, but the cool thing is, as you know, we run a scope, a picture, so we can picture, it go down the esophagus into the stomach. We could go into the duodenum. Unfortunately we can't really go past the duodenum most times, but we can also do a lower endoscopy and look at the colon and see if there's things there. So yeah, you know, we get a really good visual image of what things look like in there. We can also get biopsies. We can retrieve foreign bodies sometimes. So endoscopy is good.

Jordan Porter, RVT, LVT VTS SAIM:
It is pretty good, minimally invasive. That was hard coming out. And it's just you do get a lot of information because there's things you can't quite see how red like stomach actually is on ultrasound or on x rays. So when you go in and visually see that it looks angry, it's pretty cool. So we'll definitely to find some pictures and put up because I have several of those.

Yvonne Brandenburg, RVT, VTS SAIM:
I have a lot of pictures too. We'll put a will make a whole page. There's going to be a whole section, I'm sure of endoscopy, we just haven't made it yet. Yeah, it's definitely one of my favorite things.

Jordan Porter, RVT, LVT VTS SAIM:
We'll get there. Special tests. I've done a lot of like I said, I call them gut busters at my practice. But the G.I. panels at Texas A&M, their whole G.I. lab is great. And they actually do have a ton of good information on their website, too, about G.I. disease. But we run the TLI, PLI, cobalamine, and folate panels. So it's their big panel on cats and dogs.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. And in Jordan, I kind of talked about this beforehand because we both use Texas A&M for the GI lab. If you're if you're running a cobalamine in your clinic, or in FPL, specCPL, specFPL, whichever one it is. Take a look at them because their prices are significantly less than a lot of the kind of common laboratories. So just take a look at them. It is a little bit more cumbersome because you do have to mail it versus, you know, just having an automatic pickup. But it can save your clinic and your client a ton of money, especially if you have people that are more price sensitive. So that's definitely a huge benefit.

Jordan Porter, RVT, LVT VTS SAIM:
And the Web site's user friendly too, as long as you set up an account. You can easily print your shipping labels from there and you just package it with ice and send it on its way. It's great. And they're fast. It's pretty good.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah, we have some links on the website, too, that are for both, you know, looking at ultrasounds and some of the testing and also supplementing because vitamin B12 is kind of the one of the most common ones, especially if they're vomiting and all that stuff for diarrhea. And so we'll put the links in there for you guys, which also has the GI lab links as well.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, good stuff. Hospitalizing, which we do a lot more of, versus like outpatient care, I think was more seen in general practice. You gotta treat outpatient first before you do hospitalization. I think, unless blood panels show otherwise.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. So I remember in general practice it was more subcu fluids, anti-nausea injections, sent home with some anti-nausea injections and some bland food. I think that's probably the most common thing.

Jordan Porter, RVT, LVT VTS SAIM:
Which it does work. Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. And I would say that what works for an acute episode, I don't think for chronic that's going to be the best way to go about it.

Jordan Porter, RVT, LVT VTS SAIM:
Now I think for for definitely chronic, especially when you assess the hydration status if dehydration is an issue that pets should be hospitalized with an I.V. catheter and I.V. fluids. And then if,

Yvonne Brandenburg, RVT, VTS SAIM:
Ideally.

Jordan Porter, RVT, LVT VTS SAIM:
The patient or client permitting, hopefully,.

Yvonne Brandenburg, RVT, VTS SAIM:
And I was going to say, and finance, I mean, that's huge when we're talking to our client. We actually talked about this this week at my clinic. You want to be very careful about making judgments about people by the way that they look. You know, you can have someone with a ton of money that comes in wearing ripped jeans and duct taped shoes. You know, and they're like, yeah, no problem. Or they have insurance. So it's like, yeah, no problem. Versus someone who's dressed to the nines.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
Maybe they can't afford the gold standard treatment. So being able to present the gold standard, but also give them options and not accuse them or look down on them just because they for whatever reason either can't or won't do that treatment plan.

Jordan Porter, RVT, LVT VTS SAIM:
It needs to be like a super understanding situation. I mean we should all get it. We are all techs. We all don't make a ton of money that if we were not working in a vet clinic and this happened to our pets, like, would we be able to afford some of these estimates we give out? So, I mean,

Yvonne Brandenburg, RVT, VTS SAIM:
I've actually told clients that.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. I'm tell people that all time.

Yvonne Brandenburg, RVT, VTS SAIM:
There's no way I could do this. Yeah.

Jordan Porter, RVT, LVT VTS SAIM:
Like I 100% understand, but here was what option A is and this is what the doctor feels like is probably the best route to take. But if you can't, if we can't do that, then we will make it work with this. I think that's pretty good. And I do like to ask people if they have a number in mind so we don't exceed that price so we can try to really work within their budget. If they have a specific budget.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah, that's actually really smart.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, I can do that sometimes.

Yvonne Brandenburg, RVT, VTS SAIM:
And honestly, I mean having that conversation with them,.

Jordan Porter, RVT, LVT VTS SAIM:
It's hard.

Yvonne Brandenburg, RVT, VTS SAIM:
It is hard, but it makes it so that that pet gets the best care they can. Right. Because they only have a limited amount of funds. Well you know, if I had if I had all the funds in the world, I would run all these tests, which is great, except now we're still not treating the pet. So, knowing what they have to work with, maybe we just treat symptomatically without knowing exactly what's going on.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, especially coming from a specialty hospital. I think it's easier to see that there are times we really want to treat your pet. And so we'll forego the ultrasound. Yeah. We don't know why your pet's vomiting, but it doesn't matter right now if we just need to try to get you feeling better for a good quality of life versus a specific diagnosis. Then we'll go there. And then you save up money and maybe we can try to come back at it in a little weeks.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah.

Jordan Porter, RVT, LVT VTS SAIM:
So we do try to give people those options of like take this estimate home, look it over. Try this for now. And if this doesn't work, then we're gonna recommend an endoscopic procedure or this and this and this.

Yvonne Brandenburg, RVT, VTS SAIM:
Right. I think that's a conversation to remind doctors about sometimes, because I feel like depending on the doctor you work with. I think they just want to fix everything. Right? They're like, I can do this. I can fix it. Well, sometimes it's not about fixing it so much as like quality of life, both for pets and the owners and the family. Right? If you're making them do a medication every two hours, including overnight. Well, that's not a quality of life for either one of them necessarily. So it is that balance. And I think technicians, we have the advantage that we can sometimes bridge the gap between clients and doctors and bring it together.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, because it can be, I mean, the whole money talk in general can definitely be frustrating, especially when people don't have any money and then they're like, well, don't you want to help our pets? That's a whole different story. But yes, like, yes, we want to help pets. And yes, we will try to work with you to the best of our abilities. But at the same time, it does cost money to try to do so. So.

Yvonne Brandenburg, RVT, VTS SAIM:
Right. Yeah.

Jordan Porter, RVT, LVT VTS SAIM:
I think that's a, yeah, that's a whole other realm to dive into.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah, definitely.

Jordan Porter, RVT, LVT VTS SAIM:
And then client communication is key. You gotta communicate with your clients as to what they expect to get out of coming to your hospital.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. Yeah. And both what is expected of that visit. And then also long term, you know, what's the follow up? Or is it just a one time thing and we're done? Or, hey, you know, we need to recheck in a couple of weeks or weekly or in six months or whatever it is. What's the follow up on it? What's the long term treatment plan, especially the vomiting? You know, if it's, if it's an easy fix, like let's say it's a food responsive, vomiting gastroenteritis kind of thing. Well, then great. The food fixed it. Hopefully you stay on that diet. And we don't have to see you. But that maybe it's not just food related. And we have to do further, you know, specialty care.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
And this is something to working in a general practice. Hopefully you have a relationship with the doctors that you work with that you feel comfortable and empowered to do to question, not them necessarily, but question the treatment plan and be like, hey, I don't understand. Do you think it might be a good idea to send it to specialty practice? You know, can we do a referral? Because honestly, I will tell you right now, if you don't work in a specialty practice: we don't want to keep your clients. I don't want to keep them.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, definitely not.

Yvonne Brandenburg, RVT, VTS SAIM:
You know, there's plenty of times I'm like, no, please go back to your general practice vet. I have no idea about anything when it comes to flea products. I don't know. We don't even have vaccines in my hospital. So I'm not even doing that.

Jordan Porter, RVT, LVT VTS SAIM:
No, we don't either.

Yvonne Brandenburg, RVT, VTS SAIM:
We don't have dental equipment in my hospital. So there's very specific things that are general practice things versus specialty.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. we don't even sell food. We just try to get people an answer and then we're like, go buy the food from your regular vet.

Yvonne Brandenburg, RVT, VTS SAIM:
Very rarely sell the food. We give them samples sometimes and then we're like, please go get it somewhere else. It's too expensive here. Please go, go.

Jordan Porter, RVT, LVT VTS SAIM:
So, yes, most most special specialty hospitals are willing to work with general practice and give you your patient. I don't know if a lot of general practices are always willing to have a patient back, but we.

Yvonne Brandenburg, RVT, VTS SAIM:
I have been there. I'm like, you need to go to UC Davis. They can solve all your problems. Yeah, we know those patients when they walk through our door.

Jordan Porter, RVT, LVT VTS SAIM:
But I think keeping the lines of communication open, though, with your client and just finding out find out from your veterinarian, like what is next if this doesn't work? And then keeping the lines of communication where, you know, Miss Smith calls and Buddy still, he did great for a whole month on the new diet. But as soon as we came off of cerenia, he vomited once but then he was good. You know, it's just kind of taking those minor notes to see, like what changed and, you know, now he's going to the dog park, but he still vomits maybe once every other week. And so I think it's just, I know we're talking about cats, but I got stuck on dogs.

Yvonne Brandenburg, RVT, VTS SAIM:
I know. I was like, oh, my cat to the dog park. I mean, it definitely translates to either one of them. Really. I mean.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah, I mean, hey, cats walk on leashes now. So they do go outside and go places.

Yvonne Brandenburg, RVT, VTS SAIM:
My cat acts like he's dead when I put the leash on him, he just like falls over. It's really funny.

Jordan Porter, RVT, LVT VTS SAIM:
I love it.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. And when we're talking about, you know, food trials, does the vomiting, continue? Probiotics. Did we talk about probiotics?

Jordan Porter, RVT, LVT VTS SAIM:
We have not yet, but I know yet. It's definitely a topic.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah, so probiotics are great. There's prebiotics. There's probiotics. And we'll talk about that I think a little bit more in depth in the lower G.I. stuff, because we're talking upper G.I. We're going to talk lower GI. And I think probiotics definitely play more of a role in there. So we'll talk about it. Yeah. I think communication, client communication and follow up is huge.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
And then as far as cautions for vomiting. I think the biggest things that we see is dehydration. Right? We all know about that. So making sure our pets don't become dehydrated: either subcu fluids or or I.V. fluids. Plenty of fresh water for them. And then aspiration. I feel like trying to think of the last time I saw an aspiration pneumonia on a cat. I think it was probably like post-op and there was a lot of stuff going on with the cat.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah.

Yvonne Brandenburg, RVT, VTS SAIM:
I don't think it happens nearly as much. But dogs for sure. You know, the especially regurgitation, I feel they get more aspiration than vomiting because that projectile comes out, whereas regurgitation not so much. Keeping an eye on that. Telling clients what to look for as far as aspiration goes. So the other thing we have is the tip of the week.

Yvonne Brandenburg, RVT, VTS SAIM:
It's the tip of the week.

Yvonne Brandenburg, RVT, VTS SAIM:
So we I think the regurg versus vomiting is huge when you're talking to your clients. So I think that's one of the big tips of the of the week. And then the other is the handout for getting history from your clients. So we'll have that in the in the show notes.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. Because it's something that you can definitely take into your clinic and try to implement it and try to just get more thorough histories.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. And Jordan and I, we talked about this a little bit earlier, it doesn't matter if your clinic is paper, or paperless, or paper light. You can use the handout and you can if you need something where you want to upload it to your computer, let us know. You can send us an email. I'm happy to send you a version that you can upload and use. I use EzyVet in my clinic. So I have a template in EzyVet that I use for every appointment for histories. You know, Jordan, I think right now she's doing more handwritten and then getting it in the computer. So again, depending on what your clinic uses, but you can use a template to make things much easier.

Jordan Porter, RVT, LVT VTS SAIM:
Yeah. So I think we covered some good stuff. Hopefully you got a lot out of this episode.

Yvonne Brandenburg, RVT, VTS SAIM:
And now for the Question of the Week.

Jordan Porter, RVT, LVT VTS SAIM:
So what was the most surprising thing that we talked about that you or that you learned today? How can you incorporate something that you learned today into your practice? So if you want to leave us a comment, we would be happy to kind of shout out next week if you have any good tips or if you have a funny story or just something surprising that you want to share.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah. Please answer the question the week, you guys. It helps us to know stuff about you and also what you would like to talk about. So definitely the question of the week. And like Jordan said, well, we'll mention you on the podcast and it can be podcast famous. Because I know there's so many of you guys out there and you have brilliant ideas on how to incorporate things. And you know what would help you? So being surprised by something and and how you're going to use it, which is really kind of cool, actually. So. So definitely check out the Web site, which is going to be www.internalmedicineforvettechs.com/podcast. And we'll make sure to get everything up there and get it updated for you.

Jordan Porter, RVT, LVT VTS SAIM:
And we look forward to hearing from you guys. Let us know what else you want us to talk about and if you have any questions or just cool stories that you want share.

Yvonne Brandenburg, RVT, VTS SAIM:
Yeah, definitely. We can definitely leave a comment. You can e-mail us. All of our information is going to be on the Web site. All the resources that we talked about, plus some show notes. So if there's anything we talked about that you really want more information on. Check out the show notes as well. And the resources will have all the links there. And I think that's it for this, the third episode. And again, celebrate your National Cat Day, give your kittycat a hug and know tell them that we know if their vomiting and hopefully they don't.

Jordan Porter, RVT, LVT VTS SAIM:
Bye!

Yvonne Brandenburg, RVT, VTS SAIM:
Thank you for listening to today's episode of the Internal Medicine For Vet Techs Podcast. If you like what you heard, we'd love for you to share with someone you think might enjoy the podcast. And make sure to subscribe so you never miss an episode. Want to give us a boost? Please leave a review on i-Tunes or your favorite pod catcher and we'll be sure to say thank you. Find out everything about us at InternalMedicineForVetTechs.com. Talk to you next week. Bye.

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Question of the Week

• What was the most surprising about what we talked about today and how can you incorporate something you learned today into your practice?